Optic nerve sheath diameter as an indirect diagnosis of traumatic intracranial hypertension

Abstract

Head injuries are defined as anatomo-functional damage of the skull and its structures, produced by direct or indirect trauma of variable energy. Among its complications, intracranial hypertension is one of the factors that favor the appearance of secondary damage; its severity and duration have been correlated with a fatal prognosis, being the main cause of death. We present the case of a white male patient, 57 years old, with a history of chronic ethylism, who after three hours of admission because of a mild cranioencephalic trauma, begins with tonic-clonic convulsion and degradation of the level of consciousness. In the absence of more specific examinations, the diameter of the sheath of the optic nerve was determined by ultrasonography, which was increased (left 7.3 mm; right 8.0 mm, respectively). As an initial behavior and faced with indirect confirmation of traumatic intracranial hypertension, the airway was secured with mechanical respiratory support, 20% mannitol perfusion and cardiovascular support. Finally, the patient was referred to a center with the possibility of providing urgent neurosurgical treatment.